How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $870.96 Median $3,981.07 Typical High $10,715.19 | Facility | None | $870.96 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,023.29 | Professional | None | $870.96 | $891.25 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,041.74 | Professional | None | $758.58 | $933.25 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $741.31 Typical High $1,122.02 | Facility | None | $645.65 | $741.31 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,445.44 | Professional | None | $660.69 | $794.33 | $1,445.44 |
Hometown Health Setting Professional Modifier None Typical Low $14.13 Median $933.25 Typical High $1,230.27 | Professional | None | $14.13 | $933.25 | $1,230.27 |
Hometown Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $1,047.13 | Professional | None | $12.02 | $12.02 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,265.80 | Facility | None | $691.83 | $691.83 | $4,265.80 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,445.44 | Professional | None | $794.33 | $977.24 | $1,445.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Nevada sits
The same service costs 4.4 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Nevada· 43rd of 51
$933
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.